Helping little ones with dysphagia and reflux drink safely from 6 months onwards
ThickenUp® Junior is an easy-to-use thickener specifically designed to help children with dysphagia or reflux drink and swallow safely.
ThickenUp® Junior helps your child continue to enjoy feeding by preserving the original taste of liquids.
IMPORTANT NOTICE: Always consult your healthcare professional before using any thickener for your child. ThickenUp® Junior is a food for special medical purposes, to be used under medical supervision. It is not suitable for those with a history or risk of necrotizing enterocolitis.
Why ThickenUp® Junior is the right thickener:
*International Dysphagia Diet Standardisation Initiative
High performance: Reaches the right thickness in a wide variety of liquids, including milks
ThickenUp® Junior’s unique composition of xanthan and locust bean gum, two thickeners, ensures the right level of thickness is reached in a wide variety of liquids, including milks.
Safe: The right level of thickness when needed
ThickenUp® Junior is the only thickener designed to reach all thickness levels according to IDDSI (International Dysphagia Diet Standardisation Initiative) standards, from level 1 to level 4, to ensure safe oral feeding in children with dysphagia and reflux from 6 months onwards, regardless of the extent of their dysphagia.
ThickenUp® Junior also reaches all thickness levels at different temperatures in liquids and maintains stability during the average feeding time (approx. 30 min).
Efficient: Adapted to children above 6 months with varying degrees of dysphagia
ThickenUp® Junior may help reduce reflux and aspiration, supporting children’s nutritional and hydration needs.
It is important to note that drink thickness required by each child varies according to their age and the extent of their dysphagia, therefore you should discuss with your paediatrician the IDDSI thickness level that is best adapted to your child’s needs.
Using the right thickener is important. Inappropriate thickness increases risks for children with swallowing difficulties and can lead to unintended consequences:
TOO THIN
- Coughing
- Liquids get into the lungs
- Liquids come through the nose during feeding
- Liquids go down the wrong way
TOO THICK
- Dehydration
- Choking
Types of thickeners you should avoid for your little ones:
Non-commercial thickeners, such as baby cereals and homemade thickening that do not guarantee the right thickness and are more time-consuming
Many thickeners that are not amylase-resistant, and may react with saliva
Adult commercial thickeners that are not adapted to children and can cause inflammation of the gut
Many thickeners that are not able to reach all desired thickness levels safely, from slightly thick to extremely thick
Taste preservation:
Unlike other thickeners, ThickenUp® Junior preserves the original taste of the liquids it thickens, and therefore ensures a more enjoyable drinking experience for your child.
- ThickenUp® Junior helps children develop their sense of taste
- ThickenUp® Junior increases drink enjoyment and diversification
- ThickenUp® Junior improves the positive experience of oral feeding and long-term taste and swallowing education
ThickenUp® Junior works very well in a wide variety of liquids. Please follow the preparation instructions below for the type of liquid you want to thicken.
Here is a practical preparation guide that you can download or print: Preparation Guide ThickenUp® Junior
For more detailed preparation information including videos, please select the type of liquid you want to thicken and scroll down:
- In water
- In milk
- In other liquids
The following will guide you on how to use ThickenUp® Junior with water
Mixing Instructions
Liquid first
Add powder
Use the dosage scoop
included in the tin
- Shake vigorously for 30 seconds
- Leave to stand for 5 minutes
- Give one gentle shake and consume
It is recommended to mix by shaking in a bottle for 30 seconds. Shaking is much more effective than stirring with a fork or hand whisk.
Dosing instructions:
The following table indicates the recommended volume of water in mL to reach each IDDSI thickness level. For example, mix 100 mL or mineral water with 2 scoops of ThickenUp® Junior to obtain IDDSI level 2 thickness.
(slightly thick)
1 scoop
(mildly thick)
2 scoops
(moderately thick)
3 scoops
(extremely thick)
5 scoops
or carbonated water
*Hard or soft water?
Hard water has a high calcium content whereas soft water is lower in calcium; therefore hard water produces a thinner mix than soft water for the same amount of ThickenUp® Junior.
- Mineral water: The calcium content of bottled mineral water is usually displayed on the label or can be obtained from the manufacturer. For example. Buxton® has calcium content of 55mg/L and Evlan® of 80mg/L (both hard waters), whereas Nestle®'s Pure Life Spring water contains 27mg/L and Nestle®'s Pure Life Sparkling water contains 11mg/L (both soft waters).
- Tap water: The calcium content of tap water varies in different locations, therefore results with tap water can vary across regions, ThickenUp® Junior dosing will need to be adapted according to the water used.
Therefore, the softer the water (i.e. the lower the calcium content), the higher the volume of water that may be needed to achieve the right thickness (i.e. up to 200mL).
Please be aware that boiling water can reduce its calcium content, thereby making the water softer that before.
Take a look at the video on how to prepare water with ThickenUp® Junior
Care must be taken to achieve the correct thickness according to the water used.
When you use a certain type of water (mineral or tap) for the first time with ThickenUp® Junior, make sure to use the IDDSI thickness test to check whether you have obtained the desired thickness based on dosing instructions. If necessary, you may need to adapt the dosage slightly to meet the desired thickness.
Click here to learn more about the IDDSI thickness test
To learn more about the IDDSI standards please visit the IDDSI website: www.iddsi.org
The following will guide you on how to use ThickenUp® Junior in different milk types (e.g. powdered or liquid formulas and cow’s milk)
Mixing Instructions: these apply to all milk types
Liquid first
Add ThickenUp® Junior powder
Use the dosage scoop
included in the tin
- Shake vigorously for 120 seconds
- Leave to stand for 5 minutes
- Give one gentle shake and consume
Whichever milk type you wish to thicken, it is recommended to mix by shaking in a bottle for 120 seconds. Shaking is much more effective than stirring with a fork or hand whisk. Shaking for 120 seconds may seem like quite an effort, but the smooth consistency of the resulting mixture is worth the effort.
Dosing instructions:
1. Breast milk
If you are breastfeeding beyond 6 months, ThickenUp® Junior has been shown to perform well in breast milk. However, please first consult your healthcare professional and note that you will need to test and adapt the dosing to your breast milk, because of the wide variations in the nutritional composition of breast milk among mothers. Remember as well that your breast milk composition will vary depending on the stage of lactation and your diet.
Please use the IDDSI thickness test to help you obtain the desired thickness of your breast milk.
To learn more about the IDDSI standards please visit the IDDSI website: www.iddsi.org
2. Powdered and liquid formulas
ThickenUp® Junior is suitable for thickening specialized formula for children above 6 months with gastrointestinal tract impairment, e.g. dysphagia, gastro-oesophageal reflux.
To thicken formula, the recommended method is to prepare the formula first according to the manufacturer’s instructions, then allow the liquid to cool to serving temperature (37°C). Once this step is achieved, use ThickenUp® Junior to thicken the liquid. This helps ensure thickness consistency across different formulas.
The following table indicates the average volume of prepared formulas recommended to reach IDDSI thickness levels 1 to 3. For example, to obtain level 1 thickness, first prepare your powdered formula (90ml of cooled boiled water + required amount of formula powder), then add 1 scoop of ThickenUp® Junior.
(slightly thick)
1 scoop
(mildly thick)
2 scoops
(moderately thick)
3 scoops
(extremely thick)
5 scoops
(powdered or ready-to-feed)*
*These values represent the average dosing obtained from testing with formulas of certain brands and must be adapted according to the actual formula used.
**IDDSI level 4 was not tested as formula at this thickness is considered unsuitable for consumption.
To learn more about the IDDSI standards please visit the IDDSI website: www.iddsi.org
3. Cow’s milk
ThickenUp® Junior performs very well in cow’s milk. The following table indicates the average volume of whole or semi-skimmed milk recommended to reach IDDSI thickness levels 1 to 4. For example, to obtain level 2 thickness using UHT whole milk (4% fat), mix 100 mL of milk with 2 scoops of ThickenUp® Junior.
(slightly thick)
1 scoop
(mildly thick)
2 scoops
(moderately thick)
3 scoops
(extremely thick)
5 scoops
(whole or semi-skimmed)*
*This has been prepared with milk at room temperature.
Take a look at the video on how to prepare cow’s milk with ThickenUp® Junior
To learn more about the IDDSI standards please visit the IDDSI website: www.iddsi.org
For all milk preparations, it is important to note that different milks may affect thickness.
When you use a certain type of milk for the first time with ThickenUp® Junior, make sure to use the IDDSI thickness test to check whether you have obtained the desired thickness based on dosing instructions. If necessary, you may need to adapt the dosage slightly to meet the desired thickness.
The following will guide you on how to use ThickenUp® Junior Junior with juices.
1. Orange juice
Mixing Instructions
Liquid first
Add powder
Use the dosage scoop
included in the tin
- Shake vigorously for 120 seconds
- Leave to stand for 5 minutes
- Give one gentle shake and consume
It is recommended to mix by shaking in a bottle for 120 seconds. Shaking is much more effective than stirring with a fork or hand whisk. Shaking for 120 seconds may seem like quite an effort, but the smooth consistency of the resulting mixture is worth the effort.
Dosing instructions:
The following table indicates the recommended volume of juices in mL to reach each IDDSI thickness level. For example, mix 100 mL of orange juice with 3 scoops of ThickenUp® Junior to obtain an IDDSI level 3 thickness.
(slightly thick)
1 scoop
(mildly thick)
2 scoops
(moderately thick)
3 scoops
(extremely thick)
5 scoops
*Orange Juice prepared was without pulp and at room ambient temperature
Take a look at the video on how to prepare orange juice with ThickenUp® Junior
It is important to note that different brands of orange juice can vary (acidity, sugar content, fibre content, pulp…).
When you use an orange juice with ThickenUp® Junior, for the first time, make sure you use the IDDSI thickness test to check whether you have obtained the desired thickness. If necessary, you may need to adapt the dosage slightly to meet the desired thickness.
Click here to learn more about the IDDSI thickness test
To learn more about the IDDSI standards please visit the IDDSI website: www.iddsi.org
2. Infusion tea
Mixing Instructions
Liquid first
Add powder
Use the dosage scoop
included in the tin
- Shake vigorously for 30 seconds
- Leave to stand for 5 minutes
- Give one gentle shake and consume
It is recommended to mix by shaking in a bottle for 30 seconds. Shaking is much more effective than stirring with a fork or hand whisk.
Dosing instructions:
The following table indicates the recommended preparation method for chamomile and fennel infusion teas: add one tea bag to boiling tap water and leave to infuse for 10 minutes, then remove the infusion bag and let the liquid cool to the desired serving temperature (37oC or ambient temperature) before adding the required ThickenUp® Junior amount to reach each IDDSI thickness level. For example, mix 100 mL of cooled-down infusion preparation with 1 scoop of ThickenUp® Junior to obtain an IDDSI level 1 thickness.
(slightly thick)
1 scoop
(mildly thick)
2 scoops
(moderately thick)
3 scoops
(extremely thick)
5 scoops
infusions*
*These values represent the average dosing obtained from testing with the selected Fennel and Chamomile infusions brands: BIO Child Tea and Green Apotheke.
Caution note: It is not recommended to mix ThickenUp® Junior with very hot liquids as this can alter the desired thickness. Additionally, shaking very hot liquids in a bottle can be uncomfortable and potentially dangerous due to air pressure build-up inside the bottle as it heats up.
It is important to note note that different types of infusion teas may vary. When you use an infusion tea with ThickenUp® Junior for the first time, make sure you use the IDDSI thickness test to check whether you have obtained the desired thickness. If necessary, you may need to adapt the dosage slightly to meet the desired thickness.
Click here to learn more about the IDDSI thickness test
To learn more about the IDDSI standards please visit the IDDSI website: www.iddsi.org
How to measure the thickness level using the IDDSI standards
This section will guide you on how to test whether you have obtained the thickness level recommended by your healthcare professional.
We recommend that you use the IDDSI test as shown in the video below, especially when you use a certain liquid type for the first time with ThickenUp® Junior.
Please note that, while the dosing instructions may vary across liquid types, the instructions shown in this video on how to measure the desired IDDSI thickness are the same for all liquid types. For the purposes of this video, water is shown as an example:
As a reminder, there are four IDDSI thickness levels:
As shown in the video, levels 1, 2 and 3 tested using the 10-second syringe flow test, whereas level 4 is tested using the fork-drip and spoon-tilt tests, according to IDDSI standards.
To learn more about the IDDSI standards please visit the IDDSI website: www.iddsi.org
